- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,914.39 / $14,338.00 / $18,720.20
| Facility | | $6,914.39 | $14,338.00 | $18,720.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,093.50 / $48,537.00
| Facility | | $5,840.42 | $13,093.50 | $48,537.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,101.43 / $13,300.30 / $20,241.34
| Facility | | $8,101.43 | $13,300.30 | $20,241.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,023.53 / $19,023.53 / $19,023.53
| Facility | | $19,023.53 | $19,023.53 | $19,023.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,672.57 / $13,495.15 / $20,839.66
| Facility | | $11,672.57 | $13,495.15 | $20,839.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $13,093.50 / $48,537.00
| Facility | | $5,840.42 | $13,093.50 | $48,537.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $10,182.70 / $27,401.13
| Facility | | $5,840.42 | $10,182.70 | $27,401.13 |